Achilles Non-Operative Protocol

0-2 Weeks

• Boot or cast on 24/7 first 6 weeks unless doing exercises
• Equinus cast for 2 weeks
• Non weight-bearing

2-3 Weeks

• Cam boot after 2 weeks (with two or three  7/16^th heel wedges, depending on comfort)
• 25% weight bearing
• Active DF to tolerance (not past neutral)

3-4 Weeks

• Cam boot, go to two heel wedges if had three. If had two wedges, stay at two.
• 50% weight bearing
• Active DF to tolerance (not past neutral)

4-5 Weeks

• Cam boot, go to one heel wedge only.
• 75% weight bearing
• Active DF to tolerance (not past neutral)

5-6 Weeks

• Cam boot, stay at one heel wedge.
• 75% weight bearing
• Active DF to tolerance (not past neutral)

6-8 Weeks

• Cam boot, zero heel wedges
• 100% weight bearing
• Begin to practice SLS balancing when full WB

After Week 8

• Regular Shoes
• Full weight bearing, no crutches
• Continue to practice SLS balancing
• Begin progressive resistance with light resistance band
• Start DLS heel raise, gradually shift toward SLS as tolerated
• Light tension belt stretch when in shoe-Stair calf stretch when able to perform SLS heel raise
• When able to walk without any pain at all in regular shoes, can begin light jogging

Running, Higher Energy Activities

• Ok to begin these gradually when able to perform single limb heel rise that is as high as the uninjured side